Assessment of Myocardial Work of the Left Ventricle before and after PCI in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome by Pressure-Strain Loop Technology

Abstract

Objectives. Noninvasive left ventricular pressure-strain loop (PSL) is a new method for quantitative evaluation of myocardial work, which is developed on the basis of speckle tracking echocardiography. It is necessary to fit the noninvasive left ventricular pressure and the strain by speckle tracking echocardiography to construct a pressure-strain loop. Compared with traditional left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), it has potential application value and is a useful supplement for clinical evaluation of left ventricular systolic function. We perform this study to evaluate the changes of myocardial function in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) before and after percutaneous coronary intervention (PCI) with noninvasive left ventricular pressure-strain loop (PSL). Methods. 33 NSTE-ACS patients admitted to the Department of Cardiovascular Medicine of the Affiliated Lianyungang Hospital of Xuzhou Medical University who successfully underwent early PCI were included as the PCI group. At the same time, 30 healthy patients matched in age and sex were selected as the control group. All patients received routine echocardiography. The parameters such as GWI, GCW, GWW, and GWE were obtained by EchoPAC 203 software. The differences in the general clinical data and echocardiographic parameters between the two groups, including controls and patients 1 day before surgery and 1 month after surgery, were compared. Results. Compared with the control group, GWI, GCW, and GWI in the PCI group were decreased 1 day before surgery and 1 month after surgery, while GWW was increased, with statistical significance ( P < 0.05 ). In the PCI group, compared with 1 day before surgery, GWI and GCW were all increased 1 month after surgery ( P < 0.05 ), and GWW and GWE were not significantly different between the two groups ( P > 0.05 ). Conclusion. The noninvasive left ventricular PSL technology can early and accurately evaluate the myocardial function impairment in NSTE-ACS patients and the recovery of myocardial function after PCI, providing a new noninvasive method for clinical postoperative myocardial function evaluation.

Echocardiographic Myocardial Work: A Novel Method to Assess Left Ventricular Function in Patients with Coronary Artery Disease and Diabetes Mellitus

“…The difference was statistically significant (p < 0.05), suggesting that the LV myocardial function was impaired. In the group treated by percutaneous coronary intervention, the values of GLS, GWI and GCW increased after 1 month as compared to those obtained 1 day before revascularization, showing that the LV systolic function was improved, while other echocardiographic parameters were not significantly different between the two groups [32]. Follow-up is necessary after revascularization to observe the value of MW and to estimate long-term prognosis.…”

Clinical research progress of myocardial work in assessment and prediction of coronary artery disease in noninvasive pressure‐strain loop technique

“…Compared to the day before surgery, the GWI and GCW in these patients increased 1 month after percutaneous coronary intervention (PCI). 36 Acute coronary occlusion is present in approximately 30% of NSTEMI-ACS patients, while MWI tends to worsen. 34,37 Therefore, MWI is particularly important in clinical practice and can be used as a basis to evaluate whether patients need to receive early revascularization therapy to improve long-term prognosis and prevent the occurrence of coronary acute adverse events.…”

“…The method of measuring MWI is superior to strain analysis due to the consideration of the effect of systolic blood pressure on myocardial contractility shortening. Compared to the day before surgery, the GWI and GCW in these patients increased 1 month after percutaneous coronary intervention (PCI) 36 . Acute coronary occlusion is present in approximately 30% of NSTEMI‐ACS patients, while MWI tends to worsen 34,37 .…”